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Sandi F, Mercer G, Geneau R, Bassett K, Bintabara D, Kalolo A. Alternative community-led intervention to improve uptake of cataract surgery services in rural Tanzania-The Dodoma Community Cataract Acceptance Trial (DoCCAT): a protocol for intervention co-designing and implementation in a cluster-randomized controlled trial. Biol Methods Protoc 2024; 9:bpae016. [PMID: 38566775 PMCID: PMC10987207 DOI: 10.1093/biomethods/bpae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Age-related lens opacification (cataract) remains the leading cause of visual impairment and blindness worldwide. In low- and middle-income countries, utilization of cataract surgical services is often limited despite community-based outreach programmes. Community-led research, whereby researchers and community members collaboratively co-design intervention is an approach that ensures the interventions are locally relevant and that their implementation is feasible and socially accepted in the targeted contexts. Community-led interventions have the potential to increase cataract surgery uptake if done appropriately. In this study, once the intervention is co-designed it will be implemented through a cluster-randomized controlled trial (cRCT) with ward as a unit of randomization. This study will utilise both the qualitative methods for co-designing the intervention and the quantitative methods for effective assessment of the developed community-led intervention through a cRCT in 80 rural wards of Dodoma region, Tanzania (40 Intervention). The 'intervention package' will be developed through participatory community meetings and ongoing evaluation and modification of the intervention based on its impact on service utilization. Leask's four stages of intervention co-creation will guide the development within Rifkin's CHOICE framework. The primary outcomes are two: the number of patients attending eye disease screening camps, and the number of patients accepting cataract surgery. NVivo version 12 will be used for qualitative data analysis and Stata version 12 for quantitative data. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values less than 0.05 will be considered statistically significant.
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Affiliation(s)
- Frank Sandi
- Department of Ophthalmology, The University of Dodoma Medical School, Dodoma, Tanzania
| | - Gareth Mercer
- Department of Ophthalmology & Visual Sciences, University of Toronto, Toronto, Canada
| | - Robert Geneau
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Kenneth Bassett
- Department of Ophthalmology, The University of British Columbia, Vancouver, Canada
| | - Deogratius Bintabara
- Department of Community Medicine, The University of Dodoma Medical School, Dodoma, Tanzania
| | - Albino Kalolo
- Department of Public Health, St Francis University College of Health and Allied Sciences, Morogoro, Tanzania
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Boniphace M, Matovelo D, Laisser R, Yohani V, Swai H, Subi L, Masatu Z, Tinka S, Mercader HFG, Brenner JL, Mitchell JL. The fear of social stigma experienced by men: a barrier to male involvement in antenatal care in Misungwi District, rural Tanzania. BMC Pregnancy Childbirth 2022; 22:44. [PMID: 35039002 PMCID: PMC8764782 DOI: 10.1186/s12884-022-04383-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Evidence has shown that male involvement is associated with improved maternal health outcomes. In rural Tanzania, men are the main decision makers and may determine women’s access to health services and ultimately their health outcomes. Despite efforts geared towards enhancing male participation in maternal health care, their involvement in antenatal care (ANC) remains low. One barrier that impacts men’s participation is the fear and experience of social stigma. This study, builds on previous findings about men’s perspectives in attending antenatal care appointments in Misungwi district in Tanzania, examining more closely the fear of social stigma amongst men attending ANC together with their partners. Methods Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers and expectant fathers. In-depth interviews were conducted with health providers, volunteer community health workers and village leaders. Interviews were audiotaped, and transcripts were transcribed and translated to English. Transcripts were organized in NVivo V.12 then analyzed using thematic approach. Results Three main themes were found to create fear of social stigma for men: 1. Fear of HIV testing; 2. Traditional Gender Norms and 3. Insecurity about family social and economic status. Conclusion Respondent’s experiences reveal that fear of social stigma is a major barrier to attend ANC services with their partners. Attention must be given to the complex sociocultural norms and social context that underly this issue at the community level. Strategies to address fear of social stigma require an understanding of the real reasons some men do not attend ANC and require community engagement of community health workers (CHWs), government officials and other stakeholders who understand the local context.
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Affiliation(s)
- Maendeleo Boniphace
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Dismas Matovelo
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania.
| | - Rose Laisser
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Victoria Yohani
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Hadija Swai
- Bugando Medical Centre (BMC), P. O. Box 1464, Mwanza, Tanzania
| | - Leonard Subi
- Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Mwanza, Tanzania
| | - Zabroni Masatu
- Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Mwanza, Tanzania
| | - Sylvia Tinka
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Hannah Faye G Mercader
- Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Mwanza, Tanzania
| | - Jennifer L Brenner
- Cumming School of Medicine, University of Calgary in Canada, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Jennifer L Mitchell
- Cumming School of Medicine, University of Calgary in Canada, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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Lupenza ET, Kihonda J, Limwagu AJ, Ngowo HS, Sumaye RD, Lwetoijera DW. Using pastoralist community knowledge to locate and treat dry-season mosquito breeding habitats with pyriproxyfen to control Anopheles gambiae s.l. and Anopheles funestus s.l. in rural Tanzania. Parasitol Res 2021; 120:1193-1202. [PMID: 33409645 DOI: 10.1007/s00436-020-07040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Abstract
Fundamentally, larviciding with pyriproxyfen (PPF) has potential to complement Long Lasting Insecticide Nets (LLINs) and indoor residual sprays (IRS) in settings where resistance to pyrethroids and residual malaria transmission exist. In this study, we evaluated the field effectiveness of larviciding using PPF to reduce dry season productivity of mosquito breeding habitats that were located by pastoralists within the study area. Using pastoralist knowledge, dry season breeding habitats in Mofu village rural Tanzania were located and monitored for larval productivity for a period of 8 months before PPF intervention. During the intervention, six out of twelve breeding habitats were treated with Sumilarv 0.5G PPF granules. The impact of deposited PPF was monitored by recording emergence inhibition of larvae collected from treated habitats compared to the appropriate control group for a period of three months and half post-intervention. During baseline, the average proportion (+SD) of adult emerged was similar between two clusters, with (0.89 + 0.22) for the control cluster and (0.93 + 0.16) for the treatment cluster of breeding habitats. Following treatment with PPF, the average proportion (+SD) of adult emerged in the treated breeding habitats was significantly low (0.096 + 0.22) compared to adults that emerged from larvae in the untreated habitats (0.99 + 0.22) (p < 0.0001). Of all emerged adults, approximately 94% were An. gambiae s.l. and the remaining 6% were An. funestus s.l. This is the first study demonstrating the usefulness of engaging pastoralist community to locate and identify hard to find mosquito breeding habitats. Reduced productivity of the targeted habitats with PPF offers prospect of implementing PPF larviciding in dry season when habitats are few and permanent to control mosquito population in rural settings.
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Affiliation(s)
- Eliza T Lupenza
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Japhet Kihonda
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Alex J Limwagu
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Halfan S Ngowo
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Robert D Sumaye
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Dickson W Lwetoijera
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania. .,School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, Arusha, Tanzania.
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Møller KS, Ngowi H, Magnussen P, Magne J, Kabululu M, Johansen MV. The effect of temperature and time on the viability of Taenia solium metacestodes in pork. Vet Parasitol Reg Stud Reports 2020; 21:100436. [PMID: 32862912 DOI: 10.1016/j.vprsr.2020.100436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/29/2020] [Accepted: 07/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Taenia solium taeniosis is a growing health problem in large parts of the world including Sub-Saharan Africa. Humans are infected by eating undercooked pork with T. solium metacestodes, which cause taeniosis. The aim of the present study was to assess the effect of increasing temperatures on T. solium metacestode viability in pork. METHODS Heavily T. solium infected pieces of pork were cooked in a water-bath at five different temperatures (40 °C, 50 °C, 60 °C, 70 °C and 80 °C) for 10-60 min. At each temperature/time point, five 5x5x5 cm pieces of pork fitted with thermometers at the core were placed in the water-bath. Controls were kept at 5 °C throughout exposure. After exposure, approximately 100 intact metacestodes were harvested and after a maximum of 6 h incubation at 37 °C in a culture media consisting of 50% porcine bile and 50% saline, the metacestodes were evaluated for viability. RESULTS The metacestodes were fully viable after cooking at a core temperature of 40 °C for up to an hour. The metacestodes were non-viable after cooking for >40 min at a core temperature over 50 °C. All metacestodes were dead after cooking for 30 min at a core temperature of 60 °C; at 70 °C, non-viability was found after 20 min and all metacestodes were dead after 10 min cooking at 80 °C. CONCLUSION Findings showed that pork pieces cooked at >80 °C for >10 min proved safe for human consumption. This means that dishes consisting of pork pieces in sizes not greater than a 5 cm cube which are immersed in continuously boiling water for at least 10 min would be safe to eat. However, pork deep-fried in oil may entail a risk due to generally shorter cooking time. More research on the cooking practises is needed in order to produce safe guidelines for risk-free pork consumption.
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Affiliation(s)
- Karen Schou Møller
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870 Frederiksberg C, Denmark..
| | - Helena Ngowi
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Pascal Magnussen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Building 7-11-50, Blegdamsvej 3 B, 2200 Copenhagen, N, Denmark..
| | - Jeanette Magne
- Danish School of Education (DPU), Campus Emdrup, Tuborgvej 164, Building D 115, 2400 Copenhagen, NV, Denmark..
| | - Mwemezi Kabululu
- Tanzania Livestock Research Institute (TALIRI) - Uyole, P.O. Box 6191, Mbeya, Tanzania
| | - Maria Vang Johansen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870 Frederiksberg C, Denmark
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Kalolo A, Mazalale J, Krumeich A, Chenault M. Social cohesion, social trust, social participation and sexual behaviors of adolescents in rural Tanzania. BMC Public Health 2019; 19:193. [PMID: 30764797 PMCID: PMC6376705 DOI: 10.1186/s12889-019-6428-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 10/31/2018] [Indexed: 11/20/2022] Open
Abstract
Background Social cohesion, defined as a glue holding society together, has been found to influence several aspects of human behavior. Social cohesion, being composed of social trust and social participation, is a social factor that may influence sexual behaviors. Unfortunately, studies investigating the influence of social cohesion on sexual behaviors among young people are scarce. This study examined the influence of social cohesion on safe sexual behavior among adolescents in rural Tanzania. Methods A cross-sectional study was conducted among 403 school adolescents of the Newala district, between May and August 2010. Socio-demographic characteristics, social cohesion (social trust and social participation) and sexual behavior (age at sexual debut, intention to use and reported condom use, number of sexual partners) were obtained through self-administered questionnaires. Data analysis was performed using descriptive statistics and binary logistic regression. Results Sexual debut at under 13 years of age was reported by 12% of the respondent. A majority (71%) reported multiple sexual partnerships and half of the participants reported to have used a condom at their last sexual encounter. The intention to use a condom was reported by 77% of the respondents. Having multiple sexual partnerships was associated with social trust only (odds ratio: 3.5, 95% CI 1.01–12.3) whereas reported condom use was related with social cohesion (odds ratio 4.8 95% CI 1.66–14.06). Social cohesion, trust or participation was not associated with young age at sexual debut or intention to use a condom. Being a female (odds ratio 2.07 95% CI 1.04–4.12.) was associated with intention to use a condom. Conclusion This study indicates that social cohesion and socio-demographic factors influence actual behavior performance and behavioral intentions. The findings point to the importance of collecting more evidence on social cohesion and sexual behaviors in different settings and designing interventions that enhance social cohesion among adolescents in order to reinforce positive sexual behaviors. Electronic supplementary material The online version of this article (10.1186/s12889-019-6428-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Albino Kalolo
- Department of Public Health, St. Francis University College of Health and Allied Sciences, P.O.Box 175, Ifakara, Tanzania.
| | - Jacob Mazalale
- Department of Economics, University of Malawi, Chancellor College, P. O Box, 280, Zomba, Malawi
| | - Anja Krumeich
- Faculty of Health, Medicine and Life Sciences, Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands
| | - Michelene Chenault
- Faculty of Health, Medicine and Life Sciences, Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands
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Moshi F, Nyamhanga T. Understanding the preference for homebirth; an exploration of key barriers to facility delivery in rural Tanzania. Reprod Health 2017; 14:132. [PMID: 29041972 PMCID: PMC5645928 DOI: 10.1186/s12978-017-0397-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/12/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is limited information on the effect of expectant parents' socio-cultural perceptions and practices on the use of skilled birth attendants (SBAs) in rural Tanzania. The purpose of this study was to explore the socio-cultural barriers to health facility birth and SBA among parents choosing home birth in rural Tanzania, specifically in the Rukwa Region. METHODS This study used a descriptive exploratory methodology. Purposive sampling was used to recruit study participants for both in-depth interviews (IDIs) and focused group discussions (FGDs). Qualitative research methods, including FGDs and IDIs, were utilized in data collection. The respondents were men and women whose youngest child had been born at home within the prior 12 months. A thematic approach was used for data analysis. RESULTS The main themes that emerged regarding barriers to the use of health facility were 1) limited decision-making by men on place of delivery; 2) low risk perception by men and its interference with health facility birth; 3) men's limited resource mobilization for health facility birth and 4) females' perceptions that pregnancy and childbirth are low-risk events. CONCLUSION This qualitative study demonstrates that apart from well-documented structural barriers to skilled birth attendance in rural Tanzania, the low risk perception among both men and women plays a substantial role. The low risk perception among both men and women affects the use of SBAs in two ways. First, women become negligent and take risk of delivering at home. Second, male partners do not seriously mobilize resources for health facility childbirth. These findings reinforce the urgent need to implement creative programs to increase genuine male participation in facilitation of health facility childbirth.
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Affiliation(s)
- Fabiola Moshi
- Department of Clinical Nursing, University of Dodoma, Dodoma, Tanzania.
| | - Tumaini Nyamhanga
- Department of Developmental Studies, Muhimbili University of Health and Allied Sciences, P.O BOX 65004, Dar es Salaam, Tanzania
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Moshi IR, Ngowo H, Dillip A, Msellemu D, Madumla EP, Okumu FO, Coetzee M, Mnyone LL, Manderson L. Community perceptions on outdoor malaria transmission in Kilombero Valley, Southern Tanzania. Malar J 2017; 16:274. [PMID: 28676051 DOI: 10.1186/s12936-017-1924-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The extensive use of indoor residual spraying (IRS) and insecticide-treated nets (ITNs) in Africa has contributed to a significant reduction in malaria transmission. Even so, residual malaria transmission persists in many regions, partly driven by mosquitoes that bite people outdoors. In areas where Anopheles gambiae s.s. is a dominant vector, most interventions target the reduction of indoor transmission. The increased use of ITNs/LLINs and IRS has led to the decline of this species. As a result, less dominant vectors such as Anopheles funestus and Anopheles arabiensis, both also originally indoor vectors but are increasingly biting outdoors, contribute more to residual malaria transmission. The study reports the investigated community perceptions on malaria and their implications of this for ongoing outdoor malaria transmission and malaria control efforts. METHODS This was a qualitative study conducted in two rural villages and two peri-urban areas located in Kilombero Valley in south-eastern Tanzania. 40 semi-structured in-depth interviews and 8 focus group discussions were conducted with men and women who had children under the age of five. The Interviews and discussions focused on (1) community knowledge of malaria transmission, and (2) the role of such knowledge on outdoor malaria transmission as a contributing factor to residual malaria transmission. RESULTS The use of bed nets for malaria prevention has been stressed in a number of campaigns and malaria prevention programmes. Most people interviewed believe that there is outdoor malaria transmission since they use interventions while indoors, but they are unaware of changing mosquito host-seeking behaviour. Participants pointed out that they were frequently bitten by mosquitoes during the evening when outdoors, compared to when they were indoors. Most participants stay outdoors in the early evening to undertake domestic tasks that cannot be conducted indoors. House structure, poor ventilation and warm weather conditions were reported to be the main reasons for staying outdoors during the evening. Participants reported wearing long sleeved clothes, fanning and slapping themselves, using repellents, and burning cow dung and neem tree leaves to chase away mosquitoes. CONCLUSIONS Community understanding of multiple prevention strategies is crucial given changes in mosquito host seeking behaviour and the increased incidence of outdoor biting. The current low use of outdoor control measures is attributed largely to limited awareness of outdoor transmission. Improved community understanding of outdoor malaria transmission is critical: efforts to reduce or eliminate malaria transmission will not be successful if the control of outdoor transmission is not emphasized.
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Mushi AK, Massaga JJ, Mandara CI, Mubyazi GM, Francis F, Kamugisha M, Urassa J, Lemnge M, Mgohamwende F, Mkude S, Schellenberg JA. Acceptability of malaria rapid diagnostic tests administered by village health workers in Pangani District, North eastern Tanzania. Malar J 2016; 15:439. [PMID: 27567531 PMCID: PMC5002154 DOI: 10.1186/s12936-016-1495-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/16/2016] [Indexed: 11/10/2022] Open
Abstract
Background Malaria continues to top the list of the ten most threatening diseases to child survival in Tanzania. The country has a functional policy for appropriate case management of malaria with rapid diagnostic tests (RDTs) from hospital level all the way to dispensaries, which are the first points of healthcare services in the national referral system. However, access to these health services in Tanzania is limited, especially in rural areas. Formalization of trained village health workers (VHWs) can strengthen and extend the scope of public health services, including diagnosis and management of uncomplicated malaria in resource-constrained settings. Despite long experience with VHWs in various health interventions, Tanzania has not yet formalized its involvement in malaria case management. This study presents evidence on acceptability of RDTs used by VHWs in rural northeastern Tanzania. Methods A cross-sectional study using quantitative and qualitative approaches was conducted between March and May 2012 in Pangani district, northeastern Tanzania, on community perceptions, practices and acceptance of RDTs used by VHWs. Results Among 346 caregivers of children under 5 years old, no evidence was found of differences in awareness of HIV rapid diagnostic tests and RDTs (54 vs. 46 %, p = 0.134). Of all respondents, 92 % expressed trust in RDT results, 96 % reported readiness to accept RDTs by VHWs, while 92 % expressed willingness to contribute towards the cost of RDTs used by VHWs. Qualitative results matched positive perceptions, attitudes and acceptance of mothers towards the use of RDTs by VHWs reported in the household surveys. Appropriate training, reliable supplies, affordability and close supervision emerged as important recommendations for implementation of RDTs by VHWs. Conclusion RDTs implemented by VHWs are acceptable to rural communities in northeastern Tanzania. While families are willing to contribute towards costs of sustaining these services, policy decisions for scaling-up will need to consider the available and innovative lessons for successful universally accessible and acceptable services in keeping with national health policy and sustainable development goals.
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Affiliation(s)
- Adiel K Mushi
- Centre for Enhancement of Effective Malaria Interventions, 2448, Barack Obama Drive, P.O. Box 9653, Dar es Salaam, Tanzania. .,National Institute for Medical Research, HQ, 3 Barack Obama Drive, 11101, Dar es Salaam, Tanzania.
| | - Julius J Massaga
- Centre for Enhancement of Effective Malaria Interventions, 2448, Barack Obama Drive, P.O. Box 9653, Dar es Salaam, Tanzania.,National Institute for Medical Research, HQ, 3 Barack Obama Drive, 11101, Dar es Salaam, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Tanga Centre, P.O. Box 5004, Tanga, Tanzania
| | - Godfrey M Mubyazi
- Centre for Enhancement of Effective Malaria Interventions, 2448, Barack Obama Drive, P.O. Box 9653, Dar es Salaam, Tanzania.,National Institute for Medical Research, HQ, 3 Barack Obama Drive, 11101, Dar es Salaam, Tanzania
| | - Filbert Francis
- National Institute for Medical Research, Tanga Centre, P.O. Box 5004, Tanga, Tanzania
| | - Mathias Kamugisha
- National Institute for Medical Research, Tanga Centre, P.O. Box 5004, Tanga, Tanzania
| | - Jenesta Urassa
- National Institute for Medical Research, HQ, 3 Barack Obama Drive, 11101, Dar es Salaam, Tanzania
| | - Martha Lemnge
- National Institute for Medical Research, Tanga Centre, P.O. Box 5004, Tanga, Tanzania
| | - Fidelis Mgohamwende
- National malaria Control Programme, Ministry of Health and Social Welfare, 6 Samora Machel Avenue, 11478, Dar es Salaam, Tanzania
| | - Sigbert Mkude
- National malaria Control Programme, Ministry of Health and Social Welfare, 6 Samora Machel Avenue, 11478, Dar es Salaam, Tanzania
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